tag:blogger.com,1999:blog-4683970826895755480.post3793153065047039690..comments2018-11-19T20:21:40.258+00:00Comments on Bruce Charlton's Notions: An evidence-free worldBruce Charltonhttp://www.blogger.com/profile/09615189090601688535noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-4683970826895755480.post-28797631024670802152013-09-11T19:32:00.973+01:002013-09-11T19:32:00.973+01:00@Bill - I wasted about a decade of my life asking ...@Bill - I wasted about a decade of my life asking variations of that question in numerous articles, speeches and book chapters - crickets...Bruce Charltonhttps://www.blogger.com/profile/09615189090601688535noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-54922710469545692532013-09-11T19:27:09.904+01:002013-09-11T19:27:09.904+01:00It&#39;s kind of fun to ask &quot;evidence-based m...It&#39;s kind of fun to ask &quot;evidence-based medicine&quot; clowns if there are any RCTs demonstrating the superiority of &quot;evidence-based medicine.&quot;Billnoreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-57833966252457278942013-09-09T16:12:18.011+01:002013-09-09T16:12:18.011+01:00@ZC - very true. @ZC - very true. Bruce Charltonhttps://www.blogger.com/profile/09615189090601688535noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-9801430894612476972013-09-09T15:47:09.993+01:002013-09-09T15:47:09.993+01:00One big problem in medicine is that the consequenc...One big problem in medicine is that the consequences of treatment are often diagnosed as new disease, creating a feedback loop in which treatment causes more &quot;disease&quot; which - instead of backing down on the treatment that is causing the problem - results in more and different treatment. <br /><br />So by the time someone is elderly he is on sometimes tens of different medications, each causing the &quot;need&quot; for others - a very profitable though parasitical situation for doctors and pharma, precisely because the destruction of the life and productivity of the patient is disconnected from payment for his medical care.<br /><br />I&#39;d bet that, in a macroeconomic sense, medical care has long past reached the point of destroying more productivity in aggregate than it preserves.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-46495196735058966372013-09-08T19:08:26.991+01:002013-09-08T19:08:26.991+01:00In an evidence-free world, there is a complete, ut...<i>In an evidence-free world, there is a complete, utter and absolute disconnection between what people believe and do - and what happens as a consequence.<br /><br />Indeed, it is exactly consequence-iality which is denied - since the basis of being liberated from evidence is that we can never be sure about consequences therefore everything (and I mean everything) about what we do, depends on where we bestow the benefit of the doubt.</i> -- Bruce Charlton<br /><br /><br />The strength of belief or attachment to belief can and does influence behaviour. But, the degree to which belief is up against something more primal, (such as instinct), attenuates it. For example, fear of falling is deeply instinctive--as walking to the edge of a cliff will make abundantly clear. However, if I attach you to a hang-glider, and tell you to run off that cliff you will feel a very strong aversion to doing so, (until you have done it enough times in safe conditions to override the instinctive aversion.) Of course this is not an evidence-free situation, as each successful launch demonstrates, as does what happens to things I throw off the cliff.<br /><br />This brings up the question: Do we live in an evidence-free world? <br /><br />As my hang-gliding example makes clear, the evidence of the effect of gravity is demonstrated in such a way that we don&#39;t even have to think about it. The evidence has instilled itself at a deep level. However, the reciprocal relationship between a belief and instinct in the example can shift towards or away from belief or instinct based upon experience.<br /><br />Consequences serve to strengthen or undermine belief. However, it is possible to compartmentalise or be in a state of cognitive dissonance, and this does happen as well. (Witness oncologists who smoke.)<br /><br />To address your second point: Consequences which are proximate to an event are more strongly bound to the event as causal. Stepping off the cliff and falling is an obvious example. But the more removed a future state is from an event, the more tenuous is the connection. The first is necessary and sufficient, and the second may be necessary and is seldom sufficient due to the complex interactions which contribute to the consequence, (i.e. Butterfly Effect.) In other words there is a horizon for an actor to the effects of action, and much like the weather the further out the predicted effect lies, the less accurate the predicted consequence.<br /><br />It is not the actions do not have consequences, it is just that the consequences may not be foreseeable at the time of the action.Nicholas Fulfordnoreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-67633534610116740922013-09-08T07:29:55.860+01:002013-09-08T07:29:55.860+01:00@Th - The golden age for medical progress was abou...@Th - The golden age for medical progress was about 1935-65, since when progress first slowed up and now has probably reversed (overall)<br /><br />http://qjmed.oxfordjournals.org/content/98/1/53.full<br /><br />But the level of dishonesty in doing and reporting medical research is now so extreme, that really nobody in the world knows what is going-on anymore.Bruce Charltonhttps://www.blogger.com/profile/09615189090601688535noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-68917334513000859862013-09-08T01:50:20.586+01:002013-09-08T01:50:20.586+01:00Yes, but . . . up until the last 100 years or so m...Yes, but . . . up until the last 100 years or so medical professionals were mostly distinguished by killing their patients. Not much has changed in their character, so far as I can see. For example, people in all rich countries get way to much medical care, and doctors aren&#39;t exactly going to lead the charge against that.<br /><br />So, we&#39;re stuck between bureaucratic and corporate corruption and corruption of the profession.Thursdayhttps://www.blogger.com/profile/13002311410445623799noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-90390941145834739352013-09-07T17:37:20.876+01:002013-09-07T17:37:20.876+01:00This is part of the modern mindset, or disease, pr...This is part of the modern mindset, or disease, promoted by leftism. Experience counts for nothing. <br />Online forums are a good place to study the phenomenon. <br /><br />If I state knowledge, gained from experience, I am called upon to &#39;quote sources&#39; and &#39;provide proof&#39;. <br />Because, experience, and the lessons learned from such experience, mean nothing to one who has not experienced anything. <br />Indeed, many people actually don&#39;t experience anything. Whatever they think they know, comes from YouTube and Wikipedia, along with their most recent high school lessons, and the quoted words of long-dead people that everyone has heard of. <br /><br />Time was, the individual&#39;s experience of life could be added to the sum of general knowledge about the nature of life. But now, it is scorned and wasted, derided as being only one person&#39;s &#39;subjective&#39; experience. <br /><br />So be it. <br />The Crowhttps://www.blogger.com/profile/04323413604073160469noreply@blogger.com